CTO 59

 RCA CTO  #2-#3CTO 

AL8Fr sionblack advanced just proximal to the end of CTO lessio. GAIA2 3D wiring failed.  Then exchanged GW to Konfienza ST with MC. AG shows SI was created with some contrast.  SI is huge space.Anyone would think that this condition would be difficult to treat with antegrade. but we can do it. 

IVUS guide ,IVUS shows wire in intimal without distal part of CTO. When starting TDADR, sion black accidentally advaned to true lumen media, Swithed sionblack and guradius failed, change GW to ST advancing  with intentional direction to upper and front on AG(it means toward DTL), ST advanced DTL, swiched sionblack to cross.

big SI are fenestrated by CB. Stentigng

皮一枚でST効果。